Omission of the kidney

Considering X-ray pictures of the lumbar region or anatomical illustrations of the location of internal organs, you can see that one kidney, the right one, is always slightly lower, about 1.5-2 cm, relative to the other, the left one. This position of the kidneys is considered the norm. The pathology develops in the event that the omission of the kidney is clearly higher than the indicated indices. In this case, we are talking about nephroptosis, a pathology in which one or both of the kidney structures "leaves" their habitual location and is located in the lower abdominal cavity.

[1], [2], [3], [4]

Causes of the ovulation of the kidney

Norm and abnormality in the location of the kidneys

In the natural state, the kidney is not a strictly fixed organ. It is characterized by a certain movement, "free running", which contributes to a better process of filtration and urination. In the prone position, the kidney is practically at the same level, relative to each other, at the moment when the body assumes a horizontal position, one kidney goes slightly lower. In the course of active movements that we make during the day, the kidney can alternately rise and fall within the limits of the acceptable physiological norm.

Such movements are possible due to the constant intra-abdominal pressure, which is created due to the interaction of the diaphragm and the muscles of the abdominal press. Each kidney is surrounded by three capsules or membranes. The innermost is fibrous, then the fatty and outer - connective tissue membrane. The constancy of one's position is due to each of these shells and the help of intra-abdominal pressure.

An important role is played by the muscular skeleton of the lumbar region and the density of the whole body's muscle mass. In the case when a person has pronounced muscular weakness, frequent catarrhal symptoms are observed, multiple chronic diseases, especially in the urinary system, there is a favorable moment for the development of renal pathologies and the omission of the kidney, just one of them. The general depletion of the body leads to a reduction in the fat layer, including the thinning of the fatty capsule around the kidneys, which leads to a weakening of the ligament apparatus as a whole.

Several reasons have already been mentioned, due to which the kidney can develop - this is the lack of muscle mass, constant and general exhaustion of the body. Among other reasons, you can name: 

• low intra-abdominal pressure due to poor tone of the abdominal muscles, which is often observed in multiple-birth women; 
• abdominal and lumbar injuries, accompanied by internal hematomas. Peripheral hemangioma results in a significant displacement of the kidneys. As a result of a strong deviation from the physiological bed, the ligamentous apparatus is stretched; 
• weakness of its own ligamentous apparatus of the kidneys; 
• a sharp, uncontrolled weight loss, as a result of an improper diet or a strong infectious process.

Enumerating the reasons that can lead to the omission of the kidney, we should immediately mention a risk group, which includes people who are predisposed to the development of this type of pathology. This applies, in the first place, to women: 

• often giving birth; 
• with multiple pregnancies; 
• asthenic constitution; 
• suffering from acute or chronic pyelonephritis; 
• gravitating to various experimental diets aimed at rapid weight loss.

In men, omission of the kidney is much less common, mainly because of injuries, the consequences of heavy physical labor or exhaustion after a previous illness. Therefore, they are at risk if they fall. That's just for some indicators, such as, asthenic physique, chronic kidney and urogenital pathologies.

[5], [6], [7], [8], [9], [10]

Symptoms of the ovulation of the kidney

The omission of the kidney takes place in three stages or stages of development. At the first stage, no significant external manifestations are observed. You can see the displacement of the organ only in case of a diagnostic examination. The kidney moves relative to the vertical axis, usually after heavy physical labor. The kidney returns to its original, normal position, after the person lies on a flat surface and is at rest. The only hint at the omission of the kidney, can serve as a minor pulling pain in the lumbar region, becoming more pronounced with physical exertion.

But such "little things" rarely attract close attention from the person. Minor pains are associated with simple physical fatigue. Therefore, the manifestation of nephroptosis in the first stage is detected quite by accident, by routine medical examination or the kidney is not being dropped, at any stage of development.

At the second stage, there are deeper and more serious changes in the pericardial space. During the "unauthorized" movement of the kidneys, the vascular bundle, the ureter, is stretched and twisted. Major trunk vessels, renal vein and artery undergo a decrease in the lumen in half, which leads to a violation of blood flow, both in the kidney itself and in general. Violations begin in the urination and urination. Painful sensations are more pronounced, localized not only in the lumbar region, but also in the lower abdomen. In the analysis of the urine of such patients, the indices of protein and erythrocytes were increased.

The third stage of nephroptosis is characterized by a pronounced clinical picture. Changes that occurred in the second stage, are beginning to progress. Blood (venous) pressure in the kidney increases (hypertension), kidney tissues suffer from lack of oxygen due to poor arterial blood supply, leading to the development of ischemia of the kidney tissue. Stagnant processes lead to edema around the kidneys and inflammation inside them. A broken ureter obstructs the outflow of urine, which is why it constantly accumulates, expanding the renal pelvis. The pain becomes constant, intense, not passing even after taking a horizontal position and being at rest. In the urine there is blood, the analysis shows highly inflated indices of protein and leukocytes. Along with all internal changes, emotional instability is observed, irritability, a sense of fear increases.

Complications and consequences

The omission of the kidney is not as dangerous in itself as the complications that arise against its background. Because of stagnant phenomena in the region of the lowered organ, there is a disturbance in the nutrition of the kidney tissue, edema of the pericostal region, a difficulty in the outflow of urine, an increase in local and general venous pressure, which results in the rupture of small vessels and the discovery of internal bleeding in the cavity of the kidneys themselves.

The consequence of all these disorders, in addition to hemorrhage, is an attached infection, in the form of extensive pyelonephritis. This includes hydronephrosis and the development of orthostatic hypertension, in which the upper limit of blood pressure approaches 280, the lower one about 160.

[11], [12], [13], [14], [15]

Diagnostics of the ovulation of the kidney

Any diagnosis begins with an examination of the patient, evaluation of external parametric data, palpation of the painful zone. Palpation is always necessary and carried out, as in the horizontal position of the patient, and with the vertical. In the case of diagnosis of the omission of the kidney, with the vertical position of the body, the pathological kidney is easily palpated, which greatly facilitates the further diagnosis of ovulation of the kidney.

When complaints of  pain in the lumbar region, it is necessary to check the symptoms of Pasternatsky, which gives a positive result in the development of renal pathologies. It is necessary to conduct a detailed interview with the patient, in order to identify possible causes, which resulted in the development of a painful process.

Certain general tests are prescribed, among which the result  of a urine test, in which, as a rule, high values of white blood cells, protein and erythrocytes are found, the color of urine has a reddish tinge due to the impurity of blood. In the general analysis of blood, in the presence of a concomitant inflammatory process in the kidney, the rate of erythrocyte sedimentation rate (ESR) increases.

Among the instrumental methods of research, omission of the kidney helps diagnose methods such as: 

• ultrasonography; 
• urography (X-ray with contrast medium) in the supine position, standing and on the side. Pictures in different positions are necessary in order to clearly determine the degree of severity of pathology; 
• pyelography and angiography; 
• MRI and computer tomogram.

[16], [17], [18], [19], [20], [21], [22], [23]

Treatment of the ovulation of the kidney

At an early stage of development of nephroptosis, when there are no signs of development of concomitant complications, maintenance therapy is conducted, aimed not at eliminating nephroptosis itself, but at maintaining and strengthening the muscular framework and fat layer in the body. Achieving good results in muscle tightening, equalizing intra-abdominal pressure, increasing the fat layer, you can "put the kidney back in place," although it takes a long time to achieve a positive result with this approach to treatment, but serious interventions are not required.

To strengthen the tone of the muscles, it is advisable to wear a bandage; at the initial stage, it will play the role of the abdominal press, leading to intra-abdominal pressure to normal indices. In order to increase muscle and fat mass, a special diet with a high content of carbohydrates and vitamins is prescribed, a set of physical exercises aimed at raising muscle tone is selected. Thus, trying to equalize the position of the kidneys, simultaneous prevention of possible complications of nephroptosis is carried out.

In the event that complications are already present, the treatment will depend on the type of disease that has resulted from a condition such as the omission of the kidney, with the simultaneous strengthening of the muscular framework. In the most difficult situations, a radical method is shown, in which by surgical intervention, both the omission of the kidney and all the consequences of this process are eliminated. Such intervention is required in case of pronounced pain syndrome, multiple complications, accompanied by acute impairment of the functional capacity of the kidneys.

In the pre-operative period, a two-week treatment course of antibiotic therapy should be conducted to eliminate signs and manifestations of pyelonephritis or other inflammatory processes in the kidneys. The postoperative period requires strict adherence to long-term bed rest. In the first days, the foot end of the bed should be raised by ten to fifteen centimeters, this is necessary in order to avoid stagnant processes in the lower extremities, it will be easier for the kidneys and the heart to cope with the pumping of the liquid, thereby ensuring a sparing regimen for the operative organ.

Prevention

Based on the list of the main causes that lead to the development of a pathology such as kidney lowering, given above, it is possible to assume the main preventive measures to avoid meeting the discussed ailment. Good nutrition, constant training aimed at strengthening all muscle groups, especially the abdominal press, a competent approach to choosing a diet, leading to a gradual and controlled weight loss, in cases of acute need for it.

On the selection of the right diet, we need to dwell in more detail. In recent years, fashion diets are very common, with which women are fond of thinking, at times quite unreasonable, that they are overweight. Most of the fashion diets include fasting, low-calorie food, or excessive fluid withdrawal from the body. As a result of such a "diet", the body, feeling the lack of energy that it received from the splitting of food from the diet, begins to break down those fats that are in its "emergency supplies". One of these fat stores is the periphrenic fat capsule.

Depletion of fat stores, constant dehydration, low content of salts and vitamins in the body, protein starvation (during the diet, the body "extracted" the protein from the muscles in order to equalize the necessary protein balance), resulting in excellent results in reducing the body weight, revealing the elegant curves of the body. And after a while, exhausted internal organs begin, one after another, to fail, including the development of the omission of the kidney.

Women like to wear high heels, it's beautiful and makes the body visually slimmer. But with internal exhaustion of the body, as a result of the above experiments with diets, the probability of slow, but constant weakening of the ligamentous apparatus increases, which increases the likelihood that the kidney will fall.

At the very beginning it was already mentioned that women suffer from this pathology much more often than men. Here we have analyzed one example, which clearly indicates that in many ways, women themselves provoke the development of many ailments, including the omission of the kidney.

[24], [25], [26], [27]